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Pediatric Medicine

Answer 2
  1. McCune-Albright syndrome. McCune-Albright syndrome is characterized by café au lait spots, polyostotic fibrous dysplasia, and recurrent ovarian cysts; affected patients often have premature, not delayed, onset of menses. The most common cause of delayed menarche (ie, occurring after age 16 years with previous development of other secondary sexual characteristics or after age 14 years without development of other secondary sexual characteristics) is constitutional delay. This is often associated with a family history of later onset of menses. Pregnancy should always be considered in the evaluation of an adolescent with amenorrhea, regardless of whether it is primary or secondary. Prolactin-secreting tumors, which may present with or without galactorrhea, more commonly cause amenorrhea than complete lack of pubertal development. Turner’s syndrome should be considered in girls with other suggestive physical characteristics, especially short stature.

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